State Rep. Dan Frankel: Transform Pa. health care industry

In his budget address, Gov. Tom Corbett called upon Pennsylvania’s government to be bold.

In the same speech, he recommended we refuse $37 billion of our federal tax dollars to reduce the number of uninsured Pennsylvanians by half.

He rejected the opportunity to use the power of publicly funded insurance to transform and improve the health care industry in our state.

And he parted ways with other fiercely partisan Republican governors —from states as diverse as Arizona, Ohio and Michigan — who recognize that sometimes boldness means recognizing a transformative opportunity, even if that comes from a Democratic president.

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Gov. Corbett claims, paradoxically, that Pennsylvanians can’t afford to receive close to $37 billion over the next decade to enhance health care access in our state. Certainly, it may very well be good politics at a time when far-right supporters believe that government shouldn’t care for our vulnerable residents. Nonetheless, it’s bad policy — for consumers, for health care providers, and for our state budget, which I believe will suffer much more if we refuse to extend health benefits than it will from growing to serve more people in need.

Gov. Corbett acknowledges that the federal government would pay 100 percent of up-front costs — and 90 percent of long-term costs — for all of the people who weren’t previously able to access Medicaid. Many of these people are older adults who have not yet qualified for Medicare: people like veterans, or older working adults whose children have grown up.

However, the governor worries that expanding Medicaid will encourage citizens who are already eligible because they live with a serious disability, or care for a family on below-poverty wages, to sign up for a program they should have been benefiting from already.

He calls them “woodwork” people. I call them people in need, to whom our state has made a promise.

And I have news for the governor: Those deserving citizens will probably sign up in spite of his decision. Starting later this year, all Americans will be reminded of the requirement to have health insurance. They’ll also have an easy way to find it, through a simple health insurance exchange that will tell them what their options are, how much their insurance will be subsidized, and whether they’re eligible for Medicaid.

Whether or not affordable insurance through Medicaid is offered to a greater population of Pennsylvanians, our Medicaid system must coordinate seamlessly (the feds’ word, not mine) with the health insurance exchange.

So the “woodwork effect,” as opponents call it, will be coming to Pennsylvania regardless. So will the costs to modernize the way Pennsylvanians obtain health insurance. But the benefits Pennsylvania can receive will come only if we accept the offer of federal funds.

Gov. Corbett’s other claim is that we shouldn’t allow more money to go to a system that doesn’t work.

I think everyone agrees that fragmented care provided by our current system — which too often directs people to the emergency room, not the doctor’s office — needs attention. And that too many people live with untreated mental illness, because we’ve relied on a patchwork of public dollars to fill the gaps in an inadequate mental health care system.

So we should accept the federal offer to fix what’s broken.

That means when the federal government provides money to update the technology for our safety net services, we should accept it, be bold, and modernize.

When the government offers the opportunity to transform our Medicaid program to try and increase the value of health care for the very poor and elderly residents living in nursing homes, we should accept it, be bold, and innovate.

And when the federal government offers to make sure that working Pennsylvanians can access primary care services for health care, and not rely solely on the emergency room, we should be bold, and accept those taxpayer dollars for Pennsylvanians.

Yes, the governor is correct ­— health care costs in Pennsylvania must be reined in — both for government and for the private sector. When more people have access to affordable health care, our commonwealth can also require that our health care system provide much more health for the citizens it’s supposed to serve. Then we truly can help reform health care and make that health care available to more Pennsylvanians.

That requires the willingness to be truly bold.

State Rep. Dan Frankel, a Democrat who represents Allegheny County in the Pennsylvania Legislature, is the House Democratic Caucus chairman.